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Idiopathic Pulmonary Fibrosis: The Importance of Multiple-site Sampling

Idiopathic Pulmonary Fibrosis: The Importance of Multiple-site Sampling content piece image
RATIONALE: Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disease with no effective treatments available. Histology of IPF manifests in several different ways including, but not limited to, fibroblastic foci, bronchiolar epithelial hypercellularity and narrowing of vasculatures and airspaces. The histopathological evaluation of IPF lungs in basic research is often conducted based on samples collected from limited area due to the difficulty of obtaining IPF lung samples. Therefore, using multiple lung samples from different sites of the lung of patient who undergoes transplantation is very important and may give us valuable information.

METHODS: This research project involving the procurement and use of lung samples from patients with IPF was reviewed and approved by IACUC of University of South Florida (Pro00020884). Lung samples were collected from a patient who underwent bilateral lung transplantation at Tampa General Hospital. 3 lung blocks, 3-cm-sized for each, were excised from each of right and left lower lobe. Paraffin-embedded sections prepared from each part of lung was stained with H&E. Histopathological evaluation was performed under light microscope.

RESULTS: Samples collected from different areas of lung tissue of one patient with IPF showed varied histopathological apperances. Fibroblastic foci are are seen in most of the areas. Adjacence of vascular remodeling and bronchiolar epithelial hypercellularity are noted in a patchy manner.

CONCLUSION: Lung tissue shows varying levels of progression of fibrosis in different sections of the tissue in IPF. This highlights the importance of sampling from multiple sites on the lobes of the lung to ensure an accurate representation of a patient’s lungs.